Authors
Dean B Andropoulos, Sabrina T Bent, Barbara Skjonsby, Stephen A Stayer
Publication date
2001/10/1
Journal
Anesthesia & Analgesia
Volume
93
Issue
4
Pages
883-886
Publisher
LWW
Description
Incorrect positioning of central venous catheters (CVC) in infants and children may lead to serious complications such as perforation of the heart or great vessels. CVC position is not usually assessed until the first postoperative chest radiograph, potentially leaving malposition undetected for several hours. We studied a series of 452 right internal jugular and subclavian catheter placements in infants and children undergoing surgery for congenital heart disease, and measured the distance from the skin insertion site to the radiographic junction of the superior vena cava and right atrium (RA). Based on these data, the following formulae predict that a CVC will be positioned above the RA 97% of the time: correct length of insertion (cm)=(height in cm/10)− 1 for patients≤ 100 cm in height, and (height in cm/10)− 2 for patients> 100 cm in height. Weight-based recommendations were also developed which predict …
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